Biomedical subjects
Publications and source records attributed to D Nielsen.
A case of toxic shock syndrome (TSS) with meningismus as main symptom is presented. The case illustrates that, in cases of rigidity of the neck and back, not directly explainable, TSS should be considered as a possible diagnosis. Toxic syndrome (TSS) is a severe, acute infectious disease with great variations in symptomatology (1,2). Its lethality is approximately 5% (3). The prognosis depends on early diagnosis and treatment.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Right chest leads, V3R-V7R were recorded in 109 persons (40 women, 69 men, mean age 41 years) without evidence of heart disease. An rS or rSr' configuration was found in V3R in 98% and in V4R in 91%. Secondary r waves increased in amplitude and frequency in lateral leads and were found in V7R in 65%. The r or r' waves did not exceed 5 mm in amplitude in any lead. A qS configuration was found most frequently in V6R (16%) but none had qS configuration in all leads. An r/s ratio greater than one was found in eight persons, but the ratio never exceeded 1.5. Measurements of r and S wave amplitudes and ST-segment deviations in V4R in a 45 degree sitting position including deep inspiration and expiration did not change the amplitudes significantly. Normal values for QRS-amplitudes and q-duration, J-point and ST-segment measured 40 msec and 80 msec after the last QRS-deflection are presented.
During a 14 month period autopsies were performed on 107 patients with coronary heart disease and the results were evaluated prospectively with special reference to right ventricular infarction. A total of 214 regional infarcts were found, 107 (50%) of which involved the right ventricle. Right ventricular infarction was found in 90 hearts (84%), but only three isolated right ventricular infarcts were seen. Right ventricular involvement was found with equal frequency in anterior and posterior infarction (64 versus 66%), but posterior right ventricular infarcts were much larger (15% of the right ventricle was infarcted versus 1%). Proximal right coronary artery occlusion caused larger right ventricular infarction than did distal occlusion (15 versus 5 g). Right ventricular infarct size was not influenced by coronary artery disease (evaluated angiographically) in noninfarct-related vessels. Anterior right ventricular infarcts were predominantly located near the apex of the heart (to the left of the sternum), whereas posterior right ventricular infarcts were located near the atrioventricular groove (along the right sternal border). Infarct size was equal in patients who died from a first acute anterior or posterior infarct. However, posterior infarcts had more right ventricular involvement (28% of total infarct size versus 7% in anterior infarcts) leaving more of the left ventricular myocardium intact (79 versus 64%). These differences in infarct topography may explain why right ventricular involvement seldom is diagnosed clinically in patients with anterior infarction, and why left ventricular function and prognosis usually are better after posterior compared with anterior infarcts of enzymatically equal size.
A 50-year old woman developed symptoms of a neuroleptic malignant syndrome with myoglobinuric renal failure during treatment with perphenazine. After discontinuation of perphenazine and repetitive haemodialysis, the patient recovered. Clinical characteristics of the syndrome, differential diagnosis and various therapeutic possibilities are shortly reviewed.
Locoweed (Oxytropis sericea), when fed to calves at high elevations, increased the prevalence and severity of congestive heart failure. Forced exercise did not increase the prevalence of congestive heart failure, but it did increase severity. Calves consuming locoweed at high elevations developed signs and gross lesions of congestive heart failure and microscopic lesions of congestive heart failure and locoweed poisoning. Calves fed locoweed at low elevations developed only signs and lesions of locoweed poisoning.
In a double-blind controlled trial the efficacy of prophylactic metronidazole and pivampicillin to women with a history of pelvic inflammatory disease (PID) undergoing first-trimester abortion was assessed. Thirty-eight women received pivampicillin tablets 350 mg and 43 women metronidazole tablets 400 mg, given 1 h before and 4 and 8 h after the abortion. In the pivampicillin group 5 women (13.1%) and in the metronidazole group 8 women (18.6%) developed post-abortal PID, a non-significant difference (P greater than 0.05). The number of hospital days and amounts of antibiotics were not significantly different in the two treatment groups (all P-values greater than 0.05). Women with a history of PID were found to be at risk of contracting postabortal PID.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The plasma fibronectin concentration (PF) was measured in 48 patients with chronic inflammatory bowel disease (CIBD) and in 48 age- and sex-matched healthy controls, using electroimmunoassay and a functional (gelatin-binding) assay. Whereas no difference in immunochemically measured PF was found between the two groups, patients with CIBD had significantly lower gelatin-binding PF than healthy controls (p less than 0.001). Immunochemically measured PF increased, whereas functionally measured PF tended to decrease with increasing disease activity.
Explore the source record for details and available documents.
In field observations of young cattle grazing on certain high-altitude ranges infested with the locoweed Oxytropis sericea, a high frequency of clinical congestive right ventricular failure was identified. At necropsy of affected calves, there were right ventricular hypertrophy and dilation, subcutaneous edema, hydrothorax, diarrhea, and chronic passive congestion of liver. Microscopically, there was neurovisceral foamy cytoplasmic vacuolation, characteristic of locoism. An experiment was set up to test the relationship of O sericea to congestive right-ventricular failure. Preliminary investigation supports the field observation.
Many small biologicaly active peptides are derived from larger precursor forms which fulfil a variety of roles in the synthesis, segregation and intracellular migration of secretory products. Limited proteolysis may occur at several stages during this process, giving rise to products that are either degraded (e.g. the prepeptides) or discharged coordinately from their cells of origin during exocytosis (e.g. insulin and C-peptide). Molecular defects have recently been found to occur at cleavage sites in proinsulin as well as in other proproteins, and these point mutations may, in some instances, be responsible for familial metabolic disorders. The nature and cell specificity of the proteolytic enzymes involved in the conversion of the various precursor forms remains unresolved. Recent studies in our laboratory have led to the identification of precursors of glucagon and somatostatin in rat islets of Langerhans. Analysis of tryptic maps of these precursors has shown that a trypsin-like enzyme would be sufficient to cleave the C-terminally located somatostatin sequence from its precursor (relative molecular mass 12,500), but that both trypsin-like and carboxypeptidase B-like enzymes would be necessary to cleave the internal glucagon sequence from its prohormone (relative molecular mass 18,000). Molecular cloning techniques have provided valuable new approaches to analysing the structures of a variety of precursor forms, including those for insulin, gastrin, growth hormone, adrenocorticotropic hormone and the endorphins, and in the future will undoubtedly shed more light on the structures of their chromosomal genes, the mechanisms regulating their expression, and their evolutionary origins.
In two siblings with limb-girdle muscle weakness and episodic headaches and vomiting from early childhood, progressive neurologic degeneration later developed, and both children died. In one child, corticosteroids induced improvement in both cerebral and muscular symptoms that lasted 1 year. This patient had elevated blood, urine, and spinal fluid lactate levels, together with increased cardiac output and oxygen consumption at rest. Several muscle fibers were characterized by a "ragged red" appearance with the trichrome stain. Subsarcolemmal and intermyofibrillar excess of mitochondrial oxidative enzyme reaction product was correlated with abnormal mitochondrial aggregates by electron microscopy. The brain revealed focal areas of cortical degeneration and necrosis with adjacent gliosis or edema. Ferrocalcific deposits were prominent in the globus pallidus. The other sibling had similar changes in the brain at autopsy. This familial multisystem disorder especially involving the brain, skeletal muscle, and heart appears to represent a defect in some mitochondrial oxidative mechanism.
Explore the source record for details and available documents.
Explore the source record for details and available documents.